A Regional Blue Plan: Optimized End-to-End Risk Adjustment Process

Ciox-Case-Studies

At a Glance

Challenge

  • Significant overhead and difficulties in managing multiple vendors
  • Quality issues due to multiple hand-offs and touchpoints

Solution

  • Simplified end-to-end risk adjustment process
  • Analytics solution to target the optimal chases
  • Knowledge of provider data retrieval preferences to enhance retrieval yield
  • Seamless chart retrieval and coding operations
  • Dedicated account manager

Results

  • Higher program return on investment
  • Lower risk adjustment spend
  • Simplified risk adjustment experience
  • Lower provider abrasion